{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:39:26Z","timestamp":1759970366730,"version":"build-2065373602"},"reference-count":63,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T00:00:00Z","timestamp":1737244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Prone positioning is a standard intervention in managing patients with severe acute respiratory distress syndrome (ARDS) and is known to improve oxygenation. However, its effects on other organs, particularly the kidneys, are less well understood. This study aimed to assess the association between prone positioning and the development of acute kidney injury (AKI), specifically in overweight and obese patients. Methods: A retrospective pre\u2013post study was conducted on a cohort of 60 critically ill ARDS patients who were placed in the prone position during hospitalization. The development of AKI was assessed using the Acute Kidney Injury Network (AKIN) criteria, with AKI measured by both creatinine levels (AKINCr) and urine output (AKINUO). Patients were divided into two groups based on body mass index (BMI): overweight\/obese (BMI \u2265 25) and non-obese (BMI &lt; 25). Data were collected before and after prone positioning. Results: In overweight\/obese patients (n = 39, 57 cases), both the median AKINCr and AKINUO scores increased significantly following prone positioning (from 0 to 1, median p &lt; 0.01, and from 0 to 2, median p &lt; 0.01, respectively). No statistically significant changes in AKIN scores were observed in non-obese patients nor were significant differences found in either group after repositioning to supine. Conclusions: Prone positioning is associated with an increased risk of acute kidney injury in overweight and obese ARDS patients. This may be due to the kidneys\u2019 susceptibility to intra-abdominal hypertension in these patients. Further research is needed to explore optimal proning strategies for overweight and obese populations.<\/jats:p>","DOI":"10.3390\/jcm14020631","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T12:32:52Z","timestamp":1737376372000},"page":"631","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the Impact of the Prone Position on Acute Kidney Injury"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4297-5602","authenticated-orcid":false,"given":"Eden","family":"Ezra","sequence":"first","affiliation":[{"name":"Joyce and Irving Goldman Medical School, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6064-6909","authenticated-orcid":false,"given":"Itai","family":"Hazan","sequence":"additional","affiliation":[{"name":"Joyce and Irving Goldman Medical School, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Braiman","sequence":"additional","affiliation":[{"name":"Joyce and Irving Goldman Medical School, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Medical Intensive Care Unit, Soroka University Medical Center, Beer-Sheva 8410501, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Gaufberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Taylor","sequence":"additional","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adva","family":"Alyagon","sequence":"additional","affiliation":[{"name":"Joyce and Irving Goldman Medical School, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1512-9141","authenticated-orcid":false,"given":"Amit Shira","family":"Babievb","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4537-8659","authenticated-orcid":false,"given":"Lior","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Joyce and Irving Goldman Medical School, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Medical Intensive Care Unit, Soroka University Medical Center, Beer-Sheva 8410501, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/jama.2016.0291","article-title":"Epidemiology, Patterns of Care, and Mortality for Patients with Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries","volume":"315","author":"Bellani","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1001\/jama.2017.21907","article-title":"Acute Respiratory Distress Syndrome: Advances in Diagnosis and Treatment","volume":"319","author":"Fan","year":"2018","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1056\/NEJMoa1214103","article-title":"Prone Positioning in Severe Acute Respiratory Distress Syndrome","volume":"368","author":"Reignier","year":"2013","journal-title":"N. 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